CVS 1 Intro To CVS Flashcards
What is first line imaging technique from the heart?
Ultrasound
Where do the coronary arteries branch from?
Ascending aorta
Aortic sinuses
What does the right coronary artery branch into?
Right marginal
Right posterior interventricular artery
What does the left coronary artery branch into?
Left circumflex artery
Left anterior descending/interventricular
Left marginal
What is the pericardium?
Membrane enclosing the heart
Outline the structure of the pericardium
- Outer fibrous layer
- Inner double layer of serous layer with an inner visceral layer
- Outer parietal layer
What does a thickened pericardium cause?
The heart to be constrained which increases pressure
What are the three layers of tissue in the heart?
Epicardium
Myocardium
Endocardium
Describe the epicardium
Top layer
Serous membrane
Smooth outer surface of heart
Describe of myocardium
Middle layer
Made of cardiac muscle cells
Function: heart contracting
Describe the endocardium
Deep layer
Smooth inner surface of heart chambers
What are the pectinate muscles?
Muscular ridges in auricles and right atrial wall
What are the trabeculae carnae?
Muscular ridges and columns on inside of walls of ventricles
List the layers of the heart
Simple squamous epithelium
Loose connective tissue and adipose
Epicardium
Myocardium
Endocardium
Trabeculae carnae
What branches off the ascending aorta?
Right and left coronary arteries
What branches of the arch of the aorta?
- brachiocephalic trunk > right subclavian + right common carotid arteries
- left subclavian artery
- left common carotid artery
What does the endothelium in blood vessels do?
Stops blood sticking and forming plaques
What allows the heart to beat in a minimal friction environment?
Pericardial fluid
What does pericardial fluid allow?
The heart to beat in a minimal friction environment
What is a cardiac tamponade?
Compression of heart causing a fall in arterial blood pressure
What is a pericardial effusion?
Buildup of excess fluid in pericardium
What is a pericardiocentesis?
Insertion of a needle into pericardial space to remove the fluid
What is the typical cardiac output of a 70kg man at rest?
5 l/min
Why does a pericardial effusion prevent the heart properly filling in diastole?
Outer layer of fibrous pericardium cannot expand causing fluid to compress the heart - cardiac tamponade
Where do the left and right coronary artery arise form?
Left aortic sinus
Right aortic sinus
Where on the chest would you palpate for the apex beat?
Left 5th intercostal space
Midclavicular line
When do coronary arteries fill?
During diastole
Causes of pericarditis
Heart attack
Heart surgery
Viral, bacterial + fungal infection
Advantages and disadvantages of a catheter based angiography
Invasive
Picture of blockage
Dynamic - can act on issue at same time e.g. balloon, stent
Advantages and disadvantages of a CT coronary angiogram
Less invasive than catheter - dye added IV
Can’t act on it at same time - referral needed
Describe a catheter based angiography
Catheter inserted into artery in groin, arm or neck and threaded to blood vessels in heart - dye is added
X ray used to see coronary arteries
How is dye added in a CT coronary angiogram?
Intravenously
What dye is normally used for angiograms?
Iodine
What is a percutaneous coronary intervention?
Group of minimal invasive procedures used to open clogged coronary arteries
If a catheter is entered in the left wrist, list the vessels it would pass through to reach the coronary arteries
Radial > brachial > axillary > left subclavian > aorta > coronary artery
If a catheter is entered in the right wrist, list the vessels it would pass through to reach the coronary arteries
Radial > brachial > axillary > right subclavian > brachiocephalic > aorta > coronary artery
What does the left circumflex artery supply?
Left atrium and ventricle
What does the right coronary artery supply?
Right atrium + ventricle
What does the left anterior descending artery supply?
Right + left ventricle
Septum
Where do the coronary veins drain into?
Coronary sinus > empties into the right atrium
What is the cardiothoracic ratio
Ratio between the horizontal width of the heart : horizontal width of chest
What should the cardiothroacic ratio in a healthy patient be?
<50%
What can cause the cardiothoracic ratio to increase above 50%?
Ventricluar dilation
Ventricluar hypertrophy
Pericardial effusion
What are the right, left and inferior borders of the heart
Right - right atrium
Left - left ventricle
Inferior - right ventricle
Why does a blockage in the right coronary artery causes rhythm disturbance?
Supplies SAN and AVN in some people
What do the marginal arteries supply?
Respective ventricle
What supplies the apex of the heart?
Right marginal artery
What does the transverse pericardial sinus separate?
Aorta and pulmonary trunk from venous inflow to heart
